Mary Winifred Davis-Pranke, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

010221 Issued in CO

Practice address

1400 37TH St
Evans, CO 80620-1906

Phone

(970) 348-1112

Fax

(970) 348-1134

NPI assigned

Aug 11, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27043/brand/1/csg/1/fhir/r4
• Direct secure messaging: mary.davispranke.1@27043.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1902005382

  CO, Family Medicine

  Medicare reassignment NPD
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Evans, CO
  • NPI 1295732048
  NPD
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1700690252
  NPD
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Greeley, CO
  • NPI 1033762703
  NPD (past)
• Sunrise Community Health

  • Federally Qualified Health Center (FQHC)
  • Evans, CO
  • NPI 1811295264
  NPD (past)
• Wasatch Pediatrics, Inc

  • Pediatrics Physician
  • West Jordan, UT
  • NPI 1124102595

  Pediatrics

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1457760803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-350-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 37TH ST",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201906",
            "telephone_number": "970-348-1112",
            "fax_number": "970-348-1134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9071 S 1300 W",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840886672",
            "country_code": "US",
            "telephone_number": "801-565-1162",
            "fax_number": "801-565-1168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS-PRANKE",
        "first_name": "MARY",
        "middle_name": "WINIFRED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8244555-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "010221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Advantage, Inc
• Cope Counseling & Consulting, LLC
• Molly Crooks
• Dallas Mark Daniels, RDH
• Harlan David, PA-C
• Gabriel Giovanni De Santiago, CHI
• Maria S Diaz, LCSW, CAC III
• Thomas Lee Dickey, PA-C
• Ashley Dodds
• Felicia Marie Doherty, PA-C

• Nurse Practitioner in Evans, CO
• Providers in Evans, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.